The Testosterone
Revolution: Rediscover Your Energy and Overcome the Symptoms of Male
Menopause. By Malcolm Carruthers, M.D. London: HarperCollins
Publishers Limited, 2001. 238 pages. $22.95.
www.thorsons.com.
I had a lot of resistance to
reading this book. Now that I have just crossed another threshold (not
that I’m counting or anything!) and am closer to being 50 years old
than to being 35, I think a certain level of denial has been
percolating. I know I’m getting older, and I’m going through certain
changes, but I don’t want to think about it too much. I don’t have
male menopause, but reading this book was challenging at first as it
raised issues I’d rather not dwell on.
Well, The Testosterone
Revolution can help the reader to think about these things, and in
the end, that’s a very good thing. In parallel to my personal
reticence, society as a whole as well as the medical profession has
been reluctant to educate itself about the numerous physical, mental,
and emotional changes men go through when they hit “male menopause,” a
decline in usable testosterone in the body which Carruthers believes
would more properly be called andropause. Andropause typically affects
a middle-aged man who finds himself losing a number of things he may
have always taken for granted—his libido, his ability to obtain and
maintain erections, his energy, his positive attitude, his relatively
flat stomach. As a man starts to find himself going through andropause,
he may become quickly fatigued, and somewhat paradoxically may also be
much more irritable than previously. In fact, severe depression or a
serious life crisis are also not uncommon results. But a
psychologically based mid-life crisis is not necessarily connected
with the medical condition known as andropause.
As Carruthers explains, various
forms of treatment, all designed to generate more active, usable
testosterone in the male body, can provide dramatic, yet safe relief
for these symptoms. Carruthers walks us through centuries of medical
history, detailing the strong resistance to acknowledging this
condition that persists even to the present day. Fortunately, certain
intrepid physicians over past decades risked their careers to bring a
private testosterone revolution to their suffering patients. One major
problem has been getting the needy patient to a competent physician
knowledgeable about this issue. Numerous potential roadblocks
exist—the individual’s own resistance and fear, the many doctors
ignorant of or even actively hostile to treating a patient for the
symptoms of andropause, limitations that exist in the US and elsewhere
due to certain of the best medicines not being available, etc.
Carruthers identifies a lot of
fascinating points about testosterone that may not be familiar to
readers. Testosterone is present in women as well as men, though blood
levels of the hormone in men are 10-20 times that of women, and it
stimulates the libido in women as well. Testosterone affects our
health throughout life and might also be known as “the success
hormone.” Most high achievers, Nobel prize winners, Hollywood
directors, race car drivers, etc. have extremely high testosterone
levels. Interestingly, one’s level of the hormone tends to peak right
after a high-intensity challenge. For example, some of the highest
levels of testosterone ever observed were seen in race car drivers
immediately following an event. Even today many critics of andropause
theory are confused by the fact that blood levels of total
testosterone only decrease slightly up to age 70. The explanation is
that as men age, the hormone is held in the blood in unusable forms
and so less and less is biologically available to our body.
Carruthers repeatedly stresses
that alcohol wreaks havoc on testosterone levels. Beer is worse than
wine because it contains phyto-estrogens which act to partially
chemically castrate the male. As Carruthers memorably phrases it, “the
liver forgives and forgets, but the testis harbors grudges, so the
bar-room bruisers of today are likely to be the lousy lovers of
tomorrow.”
One thing Carruthers convinced me
of with a couple well-chosen horror stories—vasectomy is a risky
enterprise. In addition to some potentially horrific risks stemming
from the surgery’s immediate results, it also exposes a man to the
risk of suffering andropause, a serious side effect about which
doctors evidently rarely inform patients considering the procedure.
Testosterone replacement therapy
works! A variety of delivery techniques exist including injections,
pills, pellets, and patches that need to be replaced every six months
and which may eventually prove the clear method of choice. Carruthers
devotes an entire chapter to Viagra and the changes its appearance and
success have wrought.
This is about much more than sex. Maintaining our
vitality and virility into our middle and late years is the key to
managing stress, avoiding burnout, and to enjoying our families and
our work well into our mature years. Having overcome my initial
resistance, I have to take my hat off to Dr. Malcolm Carruthers,
dedicated activist and eloquent author, fighting the good fight to
help all of us to maximize our enjoyment of life and effectiveness for
as long as possible. Bravo!
©2000 J. Steven Svoboda
